[RickeyD]

Originally Posted by villagetinker

Under the heading of been there and done that, there is an option to switch back to traditional Medicare during the first year (before the 52nd week), after that, you may be subjected to additional Medicare costs, health questions, and underwriting for the supplemental plans. We changed at week 50, and avoided the surcharges and possible underwriting.

Any idea to the logic behind the pay more if you go back rule ?

[rivaridger1]

One of the internet articles on the subject of switching back to Medicare from an Advantage Plan note numbers of older sicker seniors are doing so as the Advantage Plans employ limitations designed to cut costs making it economically unviable to remain with the Advantage Plan insurer. It cited a Brown University study discussed in the 10/2015 issue of Health Affairs. When seniors elect to do so, buying a Medicare Supplement policy as noted previously becomes extremely problematic. While it has been said it in another post, it bears repeating; the red white and blue Medicare Card and guaranteed right to buy a Medicare Supplement policy are " gold " when you become seriously ill. Give a lot of thought to " parking" that card in a drawer instead of your wallet.

[villagetinker]

Originally Posted by RickeyD

Any idea to the logic behind the pay more if you go back rule ?

It is on the CMS website, and I was told this by the UHC rep.

[Villager Joyce]

Originally Posted by PTennismom0202

I have decided to move to a university city in Florida to get excellent health care. I've always lived in cities where the academic practices were resources for the community practices and peer review "lifts all the boats".

What city?

[Bonnevie]

Originally Posted by PTennismom0202

I have decided to move to a university city in Florida to get excellent health care. I've always lived in cities where the academic practices were resources for the community practices and peer review "lifts all the boats".

I can see that if one's general health necessitates it. but it seems extreme. most of us will be treated well by local doctors for what will probably be expected health issues for our age and we always have the option of going north to Gainesville for a teaching facility. However, teaching means much of the treatment will be done by residents not attendings. And a lot of time they are book smart but not clinically exposed. Saw a lot of book smart health care professionals in my career I wouldn't let touch me because they had no capacity to think beyond. It takes an open mind and exposure to different clinical experiences to be an exceptional doctor. Nothing is static in medicine. Look at estrogen....first the studies said it was good and women should take, then bad, then good again, now bad again. Give me a doctor with common sense and experience.

[Bogie Shooter]

Originally Posted by PTennismom0202

I have decided to move to a university city in Florida to get excellent health care. I've always lived in cities where the academic practices were resources for the community practices and peer review "lifts all the boats".

Sorry, you had to make this extreme decision. However, I feel I am getting excellent health care from my PCP and specialist I am seeing.
I did not see the need to leave TV, just because of the health service decision.
Like I have heard there must be more to your story...................

[Kkbart4@gmail.com]

Can someone explain to me,,,,,, I have Medicare and united healthcare supplemental plan. Can I see a doc in the villages system or go outside the system. Thanks for help

[outlaw]

Originally Posted by RickeyD

Any idea to the logic behind the pay more if you go back rule ?

You go on medicare advantage while you are healthy. Then, when you start having some health issues that require expensive procedures, etc., you switch back to medicare with supplemental and expect the supplemental to pick up the difference. Of course, you haven't been paying for that supplemental when you were not needing healthcare as much, so the insurance was making money. Now that you have more healthcare expenses, the insurance company needs to charge you a higher premium to offset your increased costs to them.

[outlaw]

Originally Posted by Kkbart4@gmail.com

Can someone explain to me,,,,,, I have Medicare and united healthcare supplemental plan. Can I see a doc in the villages system or go outside the system. Thanks for help

You will have to go outside the system, or convert to medicare advantage.

[Cathy H]

Originally Posted by Kkbart4@gmail.com

Can someone explain to me,,,,,, I have Medicare and united healthcare supplemental plan. Can I see a doc in the villages system or go outside the system. Thanks for help

we have the same and most doctors accept it. Only exceptions are those who don't take medicare. gives us a lot of flexibility specially when traveling around the us.

[rivaridger1]

Originally Posted by outlaw

You go on medicare advantage while you are healthy. Then, when you start having some health issues that require expensive procedures, etc., you switch back to medicare with supplemental and expect the supplemental to pick up the difference. Of course, you haven't been paying for that supplemental when you were not needing healthcare as much, so the insurance was making money. Now that you have more healthcare expenses, the insurance company needs to charge you a higher premium to offset your increased costs to them.

So based on the Brown University study referred to earlier the Advantage Plan insurer insures you as a healthy young senior profiting from the government subsidies to do so, and then employing price, access and coverage limitations, forces you back into original Medicare when you are older and sicker. You are then often times at the mercy of the same insurer as to whether they will sell you a Medicare Supplement at all, based on answers to health questions, or, if they will sell it to you, what price you will pay is dependent upon the state of your health at the time. Does it get any better then this ? A decision to stay with original Medicare and the Supplement Plan purchased when signing up in the first place, seems to have been justified. I am not knocking the insurers for " gaming "
the system. It is what it is and the responsibility for reform is elsewhere.

[NYGUY]

Originally Posted by PTennismom0202

I have decided to move to a university city in Florida to get excellent health care. I've always lived in cities where the academic practices were resources for the community practices and peer review "lifts all the boats".

Sounds like a decision a reasonable person might make. Other reasonable people may decide not to. It is good to have choices.

[Shimpy]

I am trying to understand why a doctor in a university is so much better than one that has graduated. I wouldn't want to fly with a pilot that is just learning.

[Eastwind53]

Many good doctors out there. Do your home work.

[NYGUY]

Originally Posted by Shimpy

I am trying to understand why a doctor in a university is so much better than one that has graduated. I wouldn't want to fly with a pilot that is just learning.

This may help you to understand why doctors in an academic setting may be a better choice (we are not talking about treating the sniffles or getting a flu shot)

Why an Academic or Teaching Hospital May Be a Good Choice for You

There are some definite pros and cons to working with doctors who are affiliated with these teaching centers and hospitals. Here are some pros for you to consider:

Salaried Doctors: While most doctors in private practice, and those affiliated with non-teaching hospitals, are reimbursed by insurance based on how many patients they see, or tests or procedures they offer, doctors who work at academic medical centers and teaching hospitals are usually paid on salary. That means the emphasis isn't necessarily on seeing too many patients in too short a time (although in some academic institutions it is.) Since there may be less emphasis on herding large numbers of patients through, or ordering tests or procedures, those doctors may be able to take some extra time with you.
Research and Clinical Trials: The professionals who work in academic medical centers are often interested in research, too. They are the people who run clinical trials, or who are on the lookout for new ideas. In particular when you have a rare disease or undiagnosed symptoms, these extended interests may provide answers that won't be forthcoming from a doctor in private practice.
Centers of Excellence: Academic medical systems and teaching hospitals often build "centers of excellence" which focus on certain diseases or conditions, like stroke centers, heart centers, cancer centers and others. They will group the doctors and support staff needed for these specialty centers into focused teams.
Access to Treatments: Because of the ways licensing works, there are sometimes treatments available through academic medical institutions that may not be available through private practices.
Academic Departments: Academic medical centers often offer services that are related to academics, and are therefore not found in other hospitals. For example, there may be an ethics department that can be called upon to consult with families who may have very difficult decisions to make.